急性颅内血肿术后迟发性血肿临床诊治分析

Analysis of clinical diagnosis and treatment of delayed hematoma after the surgery for acute intracranial hematoma

目的:通过观察急性颅内血肿术后发生迟发性血肿现象,探讨分析其临床诊治方法。方法:选择34例急性颅内血肿术后出现迟发性血肿现象的患者,对患者的临床资料进行分析研究,决定再次手术清除还是保守治疗。结果:34例患者中有18例患者进行再次手术清除颅内血肿,4例家属拒绝再次手术治疗,其余12例采用保守治疗。有15例恢复较好,6例中度残废,6例重度残废,3例植物生存,4例死亡。结论:急性颅内血肿术后迟发性血肿的原因一般与头部钝挫伤、颅内压发生较大变化以及颅骨骨折有关,对病情恢复情况应给予严密监控以及定时定期复查头颅CT,早发现早治疗以便保证预后恢复。

Objective To explore the clinical diagnosis and treatment for delayed hematoma after the surgery for acute intracranial hematoma through observation.Methods Clinical data of 34 delayed hematoma patients after the surgery of acute intracranial hematoma who were treated in our hospital were analyzed and studied first and then whether they were treated with another dissection or conservative treatment was confirmed. Results Of the 34 patients,18 needed another surgery for dissecting intracranial hematoma,4 got their families refused a second surgery, and the rest 12 patients adopted conservative treatment. 15 patients well recovered,6 patients were moderately disabled,6 patients were severely disabled,3 survived in vegetative state and 4 patients were dead.Conclusion The reasons for delayed hematoma after the surgery for acute intracranial hematoma are usually related to head blunt trauma,big changes of intracranial pressure,and skull fracture and it is required to closely monitor the recovery of disease and carry out periodic reexamination for skull CT, ensuring that the prognosis for recovery is good through early discovery and early treatment.